How To Exercise When You're In Pain

“No pain, no gain” won’t work as an exercise mantra if you’re already injured. In fact, pushing yourself too hard when you’re hurting can land you at the doctor’s office (or worse). Still, aches and pains are no excuse to cut out exercise altogether—you just have to be smart about it.

To help you pick a safe—but satisfying—workout when you’re injured, we found the 8 more common injuries in women over 40, and asked Kimberly Safman, MD, board certified physiatrist at Hoag Orthopedic Institute in Irvine, CA, to help you pick a substitute.

1. Carpal Tunnel SyndromeOften caused by: Repetitive motions, such as typing or writing, gardening, needlework, and golfing; or swelling due to diseases such as rheumatoid arthritis. Women's smaller wrists make them three times more likely than men to develop carpal tunnel.Avoid: Push-ups, plank pose, and any other exercise that involves excessive bending the wrist forward or back; racquet sports can also cause flare-ups.Try this instead: Chest exercises where you can keep wrists straight and protected—using machines or dumbbells. "Otherwise most exercises should be fine," says Dr. Safman. “If you play sports, make sure your equipment is the proper size and fit.”

3. Shoulder PainOften caused by: Something called impingement, says C. David Geier, MD, director of sports medicine at the Medical University of South Carolina (MUSC) in Charleston. Impingement occurs when the space between your rotator cuff muscles and the bone on top of your shoulder narrows, pinching the tendons. Arthritis and bursitis can also cause shoulder pain.Avoid: repetitive overhead exercises, such as overhead presses or lifts with free weights, as well as pastimes that require similar movements. "Activities like gardening and painting, which inherently don't cause any damage, could flare up the pain if done for hours," says Dr. Geier.Try this instead: Front shoulder raises instead of overhead presses and lateral raises. Also temporarily eliminate sports and exercises that involve repetitive shoulder movements such as tennis and golf, says Dr. Geier.

4. Shin SplintsOften caused by: A sudden increase in running mileage or intensity when you’re running or exercise walking.Avoid: running frequently, especially if you're in pain. You don't necessarily have to stop running altogether unless the symptoms are severe or getting worse, says Dr. Geier. Just cut back.Try this instead: Cross training combined with other forms of cardiovascular exercise, such as swimming or biking, that don’t involve repetitive impact.

5. Neck PainOften caused by: Stress, osteoarthritis, carrying a heavy bag over one shoulder, cradling a phone between your shoulder and neck, degenerative discs, and poor posture while sitting at a desk.Avoid: Some yoga positions, such as headstands, that put pressure on your neck, running or other high-impact moves that trigger neck pain should be avoided too, says Dr. Safman.Try this instead: Walking, cycling, Pilates, and yoga positions that do not involve your head or neck stands.

6. Plantar FasciitisOften caused by: Tight calf muscles, foot-arch problems, long distance running, and sudden weight gain.Avoid: Nothing, really, says Dr. Geier. "But if you're in pain, reduce any exercises with repetitive lower extremity impact, such as running."Try this instead: The elliptical trainer or bicycle may be preferable to running, as they do not subject the foot to the same stresses, says Dr. Geier.

7. Twisted AnkleOften caused by: Rolling or twisting your ankle in an awkward way that stretches or tears the ankle ligaments. Avoid: Any repetitive impact (like running or jogging) should be avoided in the days after the initial injury, says Dr. Geier.Try this instead: Focusing on upper-body exercise or non-weight-bearing workouts such as a stationary biking or swimming. To regain range of motion, draw the letters of the alphabet with your toes, says Dr. Geier.

8. Swollen KneeOften caused by: A tear in the meniscus (which is a c-shaped cartilage shock absorber in the knee) or ACL tears. But, says Dr. Geier, "patellofemoral pain—pain behind the kneecap—is the most likely cause of knee pain."Avoid: Any exercise that recreates the pain, especially impact and stress such as running, lower extremity weights, and activities where you’re jumping or changing direction. "Consider backing off of Stairmaster-type exercises," says Dr. Geier.Try this instead: Swimming, water aerobics, some yoga and/or Pilates if modified to avoid certain painful exercises. Also, include daily hip, thigh, and knee strengthening exercises, such as leg raises.